Evaluation of thrombin burst using laboratory tests

Thrombin burst is an important mechanism for hemostasis, including platelet activation and the enhancement and amplification of the coagulation process. Thrombin burst monitoring has been performed using hemostatic molecular markers, thrombin generation test (TGT), thromboelastography (TEG), and clot waveform analysis (CWA). In particular, CWA is a routine laboratory test that is neither time consuming nor expensive. Arterial thromboses, such as acute myocardial thrombosis and acute cerebral thrombosis, are associated with thrombin burst, and a small amount of thrombin time in CWA is useful for activated or procoagulant platelets. Thrombin burst is decreased in patients with bleeding diseases such as hemophilia A and acquired hemophilia A. Patients with clotting factor FVIII inhibitors are treated with bypass therapy, such as recombinant activated clotting factor FVII and activated prothrombin complex concentrate, which can be monitored by CWA, TEG or TGT.